Chew B H, Mastura I, Lee P Y, Wahyu T Sri, Cheong A T, Zaiton A
Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
Med J Malaysia. 2011 Aug;66(3):244-8.
Ethnicity is an important factor in diabetes care. The understanding of its effect in this country may help to improve diabetes care, glycaemic control and diabetic complication rates. This study was to determine the diabetes control profile in relation to complication rates between the three main ethnics group in Malaysia.
This nested cross-sectional study was part of the Audit of Diabetes Control and Management (ADCM), an ongoing cohort patient registry focused on diabetes control and management in the primary care setting in Malaysia. This registry registers all diabetes patients aged 18 years old and above. Demographic data, diabetes duration, treatment modalities, as well as various risk factors and diabetes complications are reported. Data was handled by statisticians using STATA version 9.
A total of 20330 patients from 54 health centers were registered at the time of this report. The majority were type 2 diabetics (99.1%) of whom 56.6% were female. The mean age was 57.9 years (SD 11.58). Malay accounted for 56.3%, Chinese 19.5% and Indian 22.5%. There were 30.3% who attained HbA1c < 7%. Among three main races more Chinese had HbA1c < 6.5% (Chi-square: X2 = 71.64, p < 0.001), but did not show less complications of nephropathy (Indian suffered significantly more nephropathy, Chi-square: X2 = 168.76, p < 0.001), ischaemic heart disease (Chi-square: X2 = 5.67, p = 0.532) and stroke (Chi-square: X2 =15.38, p = 0.078).
This study has again emphasized the existence of ethnic differences in glycaemic control and complication profiles. The Chinese diabetics suffer as many diabetes-related complications despite better glycaemic control. Further studies will need to look into other socio-genetic factors in order to provide a more personalized effective diabetes care.
种族是糖尿病护理中的一个重要因素。了解其在本国的影响可能有助于改善糖尿病护理、血糖控制和糖尿病并发症发生率。本研究旨在确定马来西亚三个主要种族群体之间与并发症发生率相关的糖尿病控制情况。
这项嵌套横断面研究是糖尿病控制与管理审计（ADCM）的一部分，ADCM是一个正在进行的队列患者登记系统，专注于马来西亚初级保健环境中的糖尿病控制与管理。该登记系统登记所有18岁及以上的糖尿病患者。报告人口统计学数据、糖尿病病程、治疗方式以及各种危险因素和糖尿病并发症。数据由统计学家使用STATA 9版本进行处理。
在本报告发布时，共有来自54个健康中心的20330名患者登记在册。大多数为2型糖尿病患者（99.1%），其中56.6%为女性。平均年龄为57.9岁（标准差11.58）。马来人占56.3%，华人占19.5%，印度人占22.5%。30.3%的患者糖化血红蛋白（HbA1c）<7%。在三个主要种族中，更多华人的HbA1c<6.5%（卡方检验：X2 = 71.64，p < 0.001），但肾病并发症（印度人肾病并发症明显更多，卡方检验：X2 = 168.76，p < 0.001）、缺血性心脏病（卡方检验：X2 = 5.67，p = 0.532）和中风（卡方检验：X2 =15.38，p = 0.078）并未减少。
本研究再次强调了血糖控制和并发症情况存在种族差异。尽管华人糖尿病患者血糖控制较好，但仍患有同样多的糖尿病相关并发症。需要进一步研究其他社会遗传因素，以便提供更个性化的有效糖尿病护理。
